I had two women come through the clinic recently with the exact same diagnosis. Osteopenia.
If you haven’t heard the word before, it means your bone density is lower than what’s considered normal, but not low enough yet to be called osteoporosis. Think of it as the stage before.
Both women were in their fifties. Both were caught completely off guard.
Here’s the thing about osteopenia. It doesn’t hurt. There’s no symptom that tells you it’s happening. And unless something specific flags it early, like a fracture from a minor bump or early menopause, Medicare doesn’t actually fund a bone density scan until you turn seventy. So most women in their fifties never find out, even if it’s already underway. These two only knew because they happened to ask for the scan.
Neither of them was expecting the result. And I understood why it rattled them. Osteoporosis carries a certain weight in how we talk about it. Hip fractures. Losing independence. The image of becoming frail. It’s the kind of word that makes you picture a much older version of yourself, arriving early.
But that fear showed up differently for each of them, because they were each coming at it from a completely different place.
One had never lifted a weight in her life. She sat across from me completely daunted. Not doing anything, and overwhelmed at the thought of starting from nothing.
The other had been eating well and strength training for years. She was doing everything right. And she still got the diagnosis. She felt like life was being unfair to her, and I don’t blame her for feeling that way.
Here’s what I’ve learned after twenty years of seeing this play out. The diagnosis is not a verdict on what you did or didn’t do. It’s information. It’s your body telling you what it needs next.
And what it needs next comes down to the things you can actually control. Not the genetics, not the years that have already passed, not what you didn’t know back then.
For the woman who’d never lifted, that meant starting small, and starting now. Bones respond to load at any age and any starting point.
For the woman who’d already been training for years, it meant something different. Not necessarily doing more if what she is doing is enough. But trusting the work she was already putting in, and understanding that the numbers on a scan don’t always move as fast as the effort behind them.
For both of them, it also meant something else. Building the right people around them. Hearing other people’s stories so they didn’t feel so alone in it. Finding health professionals who could actually explain what was happening, not just hand them a result and send them on their way. Learning enough to feel like they had some say in what came next.
I think about our bodies a bit like our homes. They’re constant work to upkeep. Sometimes it’s little things. Sometimes it’s bigger ones. Either way, the upkeep doesn’t stop, and it’s rarely something you do alone.